A study exploring the relationships between diabetic foot ulcer pain and health-related quality of life and functional status of people aged sixty years and over in Malaysia

Background: Diabetic foot ulcers are often described as painless due to peripheral neuropathy. The literature reveals that pain poses a significant problem than expected and severely affects the patient’s quality of life and functional status. There has been no research conducted in Malaysia on this aspect of the disease. The relationships between diabetic foot ulcer pain and health-related quality of life and functional status in people over sixty years in Malaysia is needed to understand the problem. Aims: To investigate the relationships between diabetic foot ulcer pain and health-related quality of life and functional status in people over sixty years in Malaysia. Methods: In a cross-sectional comparative study, 300 people over sixty years with diabetic foot ulcers were recruited from two secondary care (Clinic S) and three primary care clinics (Clinic P) in Malaysia. An interviewer-administered questionnaire was used to collect data. Five validated Malay versions of questionnaires were used: a short-form McGill pain questionnaire (SF-MPQ) to measure diabetic foot ulcer pain, the medical outcome study 36-items short-form health survey (SF-36) and the diabetic foot ulcer scale short-form (DFS-SF) to measure health-related quality of life, Katz activities of daily living (Katz ADL) and Lawton instrumental activities of daily living (Lawton IADL) to measure functional status. Data were encoded, entered onto a computer, and analysed with SPSS 21.0 software. Results: All the participants experienced diabetic foot ulcer pain. Diabetic foot ulcer pain was worse in married females, more than three health problems, having a 3rd episode of foot ulcer, having Grade 4 foot ulcers, using anti-microbial dressing and sterile water. The health-related quality of life and functional status worsened with increasing pain. Multiple linear regression showed that being female, having a Grade 4 foot ulcer, using sterile water, using anti-microbial dressing, bodily pain and bothered by ulcer care significantly contributed to diabetic foot ulcer pain. Participants in Clinic S reported much more pain compared to participants in Clinic P. Conclusion: This study has demonstrated that a holistic approach is needed when managing patients with diabetic foot ulcer pain. Additionally, this study identified areas that can be improved when providing treatment and implementing wound prevention programs for diabetic patients